Filing a Citizens Property Insurance claim: what Florida homeowners should know

What Citizens is

Citizens Property Insurance Corporation was created by the Legislature in 2002 as a not-for-profit, government entity to provide property insurance to Floridians who cannot obtain it in the private market. Its legal framework is in section 627.351(6) of the Florida Statutes. The statute describes Citizens as a residual market, meaning it is intended to be the insurer of last resort rather than a competitor to private companies.

That has two practical consequences for policyholders: eligibility rules that push policies back to private insurers, and some legal protections for Citizens that private insurers do not have.

How to report a Citizens claim

1. Call or go online. Citizens takes claims by phone through its toll-free claims line, 866-411-2742, and online through its myPolicy portal. Have your policy number, a phone number and address where you can be reached (especially if you are displaced), a description of the damage, and your mortgage company’s information.
2. Report early. The statutory notice deadlines apply to Citizens just as they do to private insurers: generally 1 year from the date of loss for a new or reopened claim and 18 months for a supplemental claim (s. 627.70132). Citizens itself encourages reporting as soon as you suspect damage, even before you know its full extent.
3. Protect and document. Make temporary repairs to stop further damage, keep receipts, and photograph everything before cleanup.
4. Work with the assigned adjuster. Citizens uses staff and independent adjusters, especially after a hurricane. The adjuster must identify themselves by name and Florida license number (s. 627.70131(3)(b)). Write down every adjuster you deal with.
5. Get the estimate. Ask for the detailed estimate. Like any insurer, Citizens must send it within 7 days after it is generated.
6. Watch the 60-day clock. Citizens must pay or deny a residential claim within 60 days after notice, subject to the same exceptions as other insurers, such as a declared state of emergency.

What is different about a Citizens claim

Immunity from some lawsuits

Section 627.351(6)(s) gives Citizens immunity from many kinds of liability. That immunity does not cover breach of the insurance contract or claims for benefits under a Citizens policy, so you can still sue Citizens if it fails to pay what the policy owes. However, the Florida Supreme Court held in 2015 (Citizens Property Insurance Corp. v. Perdido Sun Condominium Ass’n) that Citizens is immune from first-party statutory bad-faith claims. In other words, with Citizens the dispute is generally about the policy benefits themselves.

Its policy forms

Citizens writes its own policy forms, and they have changed over the years. Some forms include water damage limits, managed repair programs or other conditions that affect how certain claims are paid. Always read the policy and endorsements in effect on your date of loss, not a newer or older version.

A duty of good claims handling, in the statute

The statute directs Citizens to manage its adjusters so claims are handled “carefully, timely, diligently, and in good faith,” balanced against its duty to manage its assets responsibly (s. 627.351(6)(s)2.). It also states that Citizens policyholders should receive service never less than what is generally provided in the voluntary market.

Eligibility: the 20% rule and coverage limits

Because Citizens is meant to be a last resort, the law limits who can stay in it:

• The 20% rule. A homeowner offered comparable coverage by an authorized private insurer is generally not eligible for a new Citizens policy unless the private premium is more than 20% higher than the Citizens premium (s. 627.351(6)(c)5.). For primary residences, the same test applies to renewals on or after April 1, 2023; for non-primary residences, to renewals on or after July 1, 2024.
• Takeout offers. Private insurers may offer to “take out” Citizens policies. Read any takeout offer carefully; the coverage may differ even if the price is close.
• Value cap. Homes with a dwelling replacement cost of $700,000 or more are generally not eligible for Citizens personal residential coverage, with a higher threshold in counties the statute treats as lacking a reasonable degree of competition.

The flood insurance requirement

Citizens homeowners policies do not cover flood. Since the 2022 reforms, Citizens personal residential policies that include wind coverage must also carry separate flood insurance (s. 627.351(6)(aa)):

Policies that exclude wind and condominium unit-owner policies are exempt. Citizens may refuse coverage to an applicant or policyholder who will not keep flood insurance in force. The flood policy itself (often through the National Flood Insurance Program) has its own claim rules and deadlines that are different from your Citizens homeowners claim.

If Citizens denies or underpays your claim

1. Get the decision and the reasons in writing, including the policy language Citizens relies on.
2. Compare estimates. Ask for Citizens’ detailed estimate and set it against an independent contractor’s estimate.
3. Request DFS mediation. The state mediation program under section 627.7015 is available for Citizens residential claims, as for other insurers. See Florida property insurance mediation.
4. Check your policy for appraisal. If your Citizens policy contains an appraisal provision and the disagreement is about the amount of loss, appraisal may be an option for either side.
5. Talk to a lawyer before the deadlines run. A lawsuit for policy benefits requires pre-suit notice under section 627.70152. A Florida homeowner insurance lawyer can review whether the denial holds up under the policy.

Frequently asked questions

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